Stateline Master Document

BOOTH

IT WOULD HAVE BEEN SCIENCE FICTION NOT TOO MANY YEARS AGO-THE EXCHANGE OF VITAL ORGANS BETWEEN HUMAN BEINGS.  AND YET TODAY THE CONCEPT OF TRANSPLANTATION SEEMS ROUTINE-EXCEPT TO THOSE WHOSE LIVES DEPEND UPON IT.

S802/12:28

DENISE ALLEN-CAIN:  "YOU JUST CAN'T GET YOUR MIND AROUND THE IDEA THAT THEY'RE GOING TO TAKE YOUR LIVER OUT OF YOU AND PUT SOMEONE ELSE'S IN.

BOOTH

BEHIND THE SCENES IS A DELICATE BALLET COORDINATING THE EFFORTS OF THE FAMILIES OF THE DONORS AND MEDICAL TEAMS OFTEN SEPARATED BY HUNDREDS OR THOUSANDS OF MILES.

S806/26:45

NICHOLAS JABBOUR:  "EVERY TRANSPLANT PROBABLY REQUIRES SOMETIMES 50 PHONE CALLS.  BETWEEN THE DONOR TEAM, THE RECIPIENT TEAM, THE PATIENT, THE ORGAN PROCUREMENT AGENCY, THE OTHER HOSPITALS, ET CETERA."

BOOTH

DESPITE INCREASED AWARENESS, DEMAND CONTINUES TO OUTPACE SUPPLY, LEAVING HUNDREDS OF OKLAHOMANS ON WAITING LISTS.  ON THIS EDITION OF STATELINE, THEIR ONE HOPE AND PRAYER.

MUSIC

KYLE UP & OUT:

"LET ME LIVE."

TRT

Denise Allen Cain

17:53:       S-802

"She says "Denise?" And I say, "Yeah" "This is Mary at the hospital" She goes "we have a liver for you."

:07

Bob Turner

3:37:05        S-603

"When I began working for the United Network for Organ sharing, some 22 years ago, there were about 7,500 people on the transplant waiting list. And nationally there was a lot of discussion about the crisis in transplantation./ As of this morning at 9:45, there are 94,621 people on the national transplant waiting list waiting for 101-thousand organs...some are in need of several organs. Now if there was a crisis 22 years ago, it must be a disaster today."

:38

Nicholas Jabbour, M.D.

2:48:24

"Actually one old surgeon from Mayo Clinic, he was my mentor, he told me, if you look at the future, only two fields are gong to really be increasing, and being on the edge. One is trauma, /...and transplantation, because people are not going to be willing to accept...to die because one organ only is failing."

:28

Bob Turner

22:37:28      S-603

"Right now, about a third of all Oklahomans have signed up on the registry. "

:17

Paula Sanford

"It seems like such a little detail...but checking that box when you get your drivers license can mean the difference between life and death."

Shane Pennington, R.N.

2:16:09

"The more that I do for this job, you kind of realize that Oklahomans are people that, they're just very giving people. And in that worst time of their life they want to try to help somebody."

:17

GRAPHIC INTRO

:30

Stand up : Robert Burch

In January of 2001, Denise Allen Cain woke up to find that she couldn't walk and she was disoriented.

Her husband had already left for work, but she managed to crawl to a phone and call her parents.

:13

Twyla & Robert Allen

(Mother)

1:48:  S-804

"She really was out of it, she didn't make any sense at all she was lying on the floor and I don't know how long she had been there."

:06

Denise Allen Cain

3:20   S-802

"With liver disease you it came on so suddenly that I really didn't have a clue as to what happened or anything."

:11

Twyla

1:56:  S-804

"She was so Toxic, she just wasn't making much sense when she was talking so I immediately called the ambulance,9-1-1."

:09

Denise

5:46:11  S-802

"They took me to the hospital by ambulance and that's when we discovered that I was in liver failure and big time liver failure."

:08

Twyla

3:04   S-804

"Yeah, she was very yellow. Her eyes particularly were very yellow."

:05

Denise

4:51   S-802

"Your liver produces vitamin K which is your clotting factor. Without that you bleed. You have a hard time clotting any time you get a cut or anything."

:11

Denise

7:35    S-802

"Not only that but you develop desiccates which is fluid build up in your body and my ankles would get this big and you know it was liver disease is a horrible, horrible disease."

:12

Denise

12:28  S-802

"I was in denial. I'm not gonna need it. Naw, not gonna need it. No naw. I'm going to be fine. I'm going to be fine. You know. It's total denial.  You, you just can't, you can't get your mind around the idea that they're going to take your liver out of you and put someone else's in. And you're going to be ok and its, it's...its really hard to imagine that I mean. I knew I was sick but I've been sick before, you get better you bounce back you get better...(shakes her head) But you don't, you get worse, and you get worse."

:40

Denise Allen Cain

10:47:       S-802

"And then to have to go through another phase is to after you get on the list...it's the waiting, the waiting."

:12

Denise Allen Cain

13:46:       S-802

"From the time I got on the transplant list in February, at the end February '02 um, I started getting sicker, and sicker, and sicker. and in April, I mean I was really having a lot of the confusion and the uh, mental break down on things that we're going on around me."

:23

Twyla

5:42:        S-804

"Everyday we'd wait at home to see if the phone was going to ring and it didn't. And we hoped, we didn't want anybody to die, but somebody was going to have to do that for her to live."

:16

Denise Allen Cain

12:00:

"They wouldn't do it here. They refused to do me, here because they said a prior abdominal surgery, they were afraid that if they got in there they could find scar tissue that might hinder doing the transplant and that's why and that's the basis for why they turned me down here."

:21

Denise Allen Cain

11:14:       S-802

"It's not the people that have been on it the longest, it's the people that have the most need. They take you're uh, Creatinine, which is your kidney function, you're Bilirubin which is your liver and your pro-time which is how fast you clot and they factor that in and assign you a number between 0 and 40 and the closer you are to 40 are the most, are the most in need and when I went to Denver and went through all of their battery of tests I was a 21 and then actually transplant I was a 28. So the closer you are to 40 you are in really bad shape."

:40

Denise Allen Cain

14:25:       S-802

"They put me in the hospital in Midwest City and doctors there were in constant contact with the people in Denver and they said, get her here. Get her here as soon as you can."

:10

Denise Allen Cain  *

15:10:       S-802

"They got me to Denver and then that's when the waiting really started for me you know. "

:07

Denise Allen Cain

17:01:       S-802

"We were in the doctors' office and my mom was talking to Dr. Kouglmas and she said "but when's it going to be" and he goes "I don't know" and he goes "You have to understand somebody has to die for her to get a liver." When you, when you think about it in those terms somebody has to die so that you can live."

:27

Denise Allen Cain

17:53:       S-802

"I remember my mother's cell phone ringing and I picked it up and she says "Denise?" And I say, "Yeah" "This is Mary at the hospital" She goes "we have a liver for you."

:11

Denise Allen Cain

18:07        S-802

(she tears up) "And you just get. Oh my god. I mean I got up and I did this little dance and said oh its liver time."

:05

Denise Allen Cain

19:08        S-802

I wasn't scared. I wasn't scared, I wasn't apprehensive. I was just, let's just do this and get it over with...this was my chance to live, again."

:13

Denise Allen Cain

20:47        S-802

"I remember laying there and my husband was there and I looked at him. And I said...I made it. And he goes you did, look at you honey."

:09

Joe Cain

(Husband)

9:58:00      S-521

"She looked a whole lot better. I mean, just a couple of hours of a good liver functioning had already started cleaning her up and she looked completely different."

:10

Denise Allen Cain

23:59        S-802

"Life pretty much returned to normal oh six months after the transplant.

Doctor says, you can go back to work. You're healed."

:12

VO : Robert

Today Denise is back on the job.

She is a receptionist at OETA...one of our own, and one of thousands of lives saved by the generosity of a stranger.

:13

Denise Allen Cain

20:12:       S-802

"All I know about my donor was that he was a 48 year old man and he lived in the Denver area and what a wonderful, wonderful man. You know, um...his family. I think about it, its not...its everyday I think about its something that you don't get away from, to be so blessed to have a second chance at life."

:25

Slate

Bob Turner

17:00:07   S-603

"Every hospital is required to refer all deaths to the designated organ procurement organization. We'll get a call, we'll say OU Medical Center, and they say Mary Smith has been in a car accident, and we are about to pronounce her brain dead. So we'll send staff down to visit with the family. And to explain to them that once their loved one has been declared dead, the options of organ and tissue donation."

:31

Shane Pennington, RN

1:50:00   S-809

"When I first started this job, one of the hardest things for me to grasp was these people are probably going through the most tragic time in their life, and I'm supposed to walk in and ask them for something? But it's not like that...I'm basically going in, and just giving them another option...of donation."

:24

Bob Turner

11:40:08    S-603

"The most important thing from my point of view is that we don't become involved, and no mention is made of organ donation, until the family with their attending physician have already made the decision to withdraw care.

:17

Shane

6:39:24    S-809

"Once we've done all of our testing, and we deem what's going to be viable for transplant, and what's not viable for transplant, then we contact UNOS...which is the United Network for Organ Sharing, and they have the database for all the patients that are waiting on the list."

:17

Shane

8:07:10   S-809

"Once we do all that then we pull our list, and start making our phone calls, and once we've placed each organ that we believe that we're going to be able to place...then we turn into a travel agent...we start coordinating planes, and cars, and getting everybody landed and in the same place at the same time."

:18

Nicholas Jabbour

26:45:12     S-806

"Every transplant probably requires sometimes 50 phone calls. Between the donor team, the recipient team the patient, the organ procurement agency, the other hospitals, ect. So a very complex process. "

:31

Bob Turner

14:56:12   S-603

"There are a number of factors that determine the order in which patients print out. Length of time waiting is one factor. Severity of patient's illness is another factor."

:13

Nicholas Jabbour

23:21:14    S-806

"His name will be somewhere in a national list, sitting somewhere on the list. Where this sitting is a computerized program, so is no chance of cheating, going up and down...it's purely numerical."

:21

Shane

28:01:14    S-809

"Typically, we run the list. It goes locally sickest first...then it goes regionally, then it goes nationally."

:09

Bob Turner

16:41:02   S-603

"Your matched based on blood type, A-B-O blood type compatibility. Weight can be a factor...you can't put a heart from a two year old into a 60 year old man. Relative size is important, seriousness of your illness...length of time you are expected to live without a transplant."

:27

VO : Robert

Because transplantation has become so successful, there's more demand than ever for a health heart...lungs, kidneys, liver, pancreas and other tissues.

At the same time, there are fewer organs available, because now they test for HIV, Hepatitus C & B, and HTLV1.

:17

Shane

10:30:00    S-809

"When a patient has been pronounced brain dead you kind of have a window there. That you need to get all your testing done...get all your organ placement done and get to the O-R, or you start losing organs. I mean, the body just starts shutting down."

:14

Nicholas Jabbour

4:48:07       S-806

"Many times you get a call at 2:00 in the morning, and I'll be driving, and the first thing that's on my mind...what am I doing here? Why did I choose this profession, you know?...and then when you do the procedure, and you see how the patient just almost suddenly changes life overnight, it give you such a reward, that its beyond any physical or mental fatigue you know. And that's what keep you going I think, is seeing people really get better...fast."

:28

VO : Robert

About 600 of the 94 thousand people on the national waiting list are Oklahomans.

Last year 224 organ transplants were performed here...but 49 Oklahomans died waiting.

:17

George Selby

15:25

"We don't really have that problem on the stem cell side of the transplantation because we're using living donors we're usually using siblings donors, or an unrelated donor that has come off of the national marrow donor program that is volunteered to be a donor."

:16

George Selby

16:48

"The primary diseases that we treat with bone marrow or stem cell transplants are blood diseases uh like they have Leukemia that have blood marrow failure syndrome like a plastic anemia or Hodgkin's disease or non-Hodgkin's lymphoma and so those are all diseases that effect bone marrow so what we really need to do is get rid of the bad bone marrow and get some healthy functioning marrow back."

:28

Selby

30:45

"They get that chemotherapy and the radiation and they get that in about a week. They get the chemo is given all intravenously. The radiation is given twice a day for 4 days in a row and then the, if we are using a sibling donor the day of the transplant the sibling goes to the operating room and that's when we take the bone marrow."

:20

Selby

17:34

"And then when that's completed the transplant itself is very anti-climatic because the these bone marrow and stem cells come in a bag and they look just like a bag of blood like a blood transfusion. All of these patients have a catheter that's placed that goes in underneath their collar bone and the blood, this blood like substance just runs into that catheter an finds its way to the bone marrow we don't have to put it where it belongs and it circulates and it has a homing mechanism that finds its way to the bone marrow."

:32

Selby

33:04

"So when you put all of this hospitalization together you have one week of the chemo and radiation and then another 3 to 4 weeks after the transplant that they are in the hospital so then they are in the hospital 4 to 5 weeks."

:17

Slate

Martha Collar

Bone Marrow Transplant Recipient

S-404

25:14:15     S-607

"This is the mustard seed my friend that my best friend gave me...to symbolize the mustard seed of faith."

:08

VO : Robert

Martha Collar started a scrapbook when she was first diagnosed with leukemia in 2005.

:05

2:27:29      S-404

"Toward the end of August, I started just really feeling bad. You know, having fatigue, and feeling really weak...kind of like the flu. I went on the internet one Sunday afternoon and I just Googled the word CANCER and I went to the first website that came up. And I went straight to leukemia, I still to this day, I don't know I went to leukemia, but I went to that, and sure enough, there were every one of my symptoms right there."

:26

2:59:16       S-404

"First I started hyperventilating, and then I printed that out...and I took it to the doctor the next day. They did a blood test. This was on a Monday, the found out the results on Tuesday, and by Tuesday afternoon I was in the hospital."

:12

3:13:07      S-404

"That's how, that's how acute leukemia is. I mean it's acute so it's very fast. So, you know, they have to start treatment right away, because in three or four months your gone without treatment."

:11

VO : Robert

After chemotherapy, Martha was in remission.

In the summer of 2006, the leukemia returned, and a stem cell transplant became the only option.

:11

6:37:07      S-404

"I did a little research, and I found out the O-U Medical Centers outcomes were really slightly better than M-D Anderson's."

:06

6:58:23      S-404

"So I was able to stay here, which I was really glad about, because, you know, why go to Houston when you have a quality transplant center two miles down the road from where you live. I mean, it just would have been a huge inconvenience not to mention expense to my family to go down to Houston."

:16

7:40:14      S-404

"It just looks like a bag of blood, cause a lot of people, you say the word transplant and they think surgery...its not a surgery at all, it just goes into you like you would get a bag of blood. So the transplant itself is really pretty uneventful, it's the after effects that can be serious."

:16

Grant Clark

(Son)

8:32:11      S-121

"You know you don't realize how good you have it until that person is gone for up to like three months at a time."

:08

VO : Robert

Martha's son is in chef's school, so he's doing the cooking at home.

Cancer has given her an insight she did not have before.

:11

13:45:07     S-404

"It's just been kind of one day at a time. It's been, um...you draw strength from wherever you can. You find that you have strength that you didn't know that you had. Initially, when I was first diagnosed I was completely overwhelmed by the love and support of friends and family members, and co-workers, and...I mean it was just completely overwhelming. I mean if you ever wonder how much people care about you, just get cancer...you know...ha...because you find out really fast."

:32

John Clark

(Husband)

6:11:16      S-121

"One night, coming from the hospital, in the parking lot and I remember this like it was last night. It was cold, it was very dark, and for some reason as I was going to my car...there was a Beatles tune that just popped in my mind. And it's ...On a dark, cloudy night there's a still light that shines on me...and it just seemed like a hymn, sacred words. And I realized at that moment that the light is from all the outpouring of friends."

:41

Martha Collar

17:21:06     S-404

"...not only does it make you appreciate things more, but I think it also makes you less tolerant of nonsense.  You know, I mean, like just people who are petty, or mean, whether it's directed at you or someone else. I find myself not having the time for that."

:18

13:12:05     S-404

"It's, it's scary. Because AML has just about one of the worst, has about the worst prognosis of any type of cancer. There are few that are worse, but not many. With AML you are initially told that you have about a 30-percent chance.  So it's not good, it's not the good kind of leukemia to have...there's the chronic type, and then there's the acute type, and the acute type is not the good type...it's not the type you want to get."

:28

13:04:24     S-607

"This anti-rejection drug is...this bottle is like 800 dollars. But fortunately insurance covers most of that. But yeah, if a person did not have health insurance I can see how it would be just really difficult."

:17

26:50:03     S-607

"The first 100-days after transplant are the most critical, because that's when you're the most at risk for infection. So right now I'm on anti-biotic, anti-viral drugs, anti-fungal drugs, and anti-rejection drugs. You know, all of that. So I'll be on those for about a year. And now today is day 55, so I'm a little over half way there for the 100 days."

:25

Martha Collar

27:44:05     S-404

"With AML, if you can go two years, especially three years, you're pretty much out of the woods. Unlike other forms of cancer that can come back years down the road, AML is a fast developing cancer, but it's also quicker to cure. So if I can go two years, especially three, we'll be having a big party."

:22

Slate

Bob Turner

7:01:12     S-603

"There's talk of growing organs from stem cells, there's talk of artificial organs. If we have to depend on the supply of donor organs, from the number of people who die in this country, there will never be enough. And yet even today we are probably only getting about 50 percent of the organs, that could be available. "

:16

Selby

11:42:

"An embryonic stem cell has the potential to grow an entire human being these are a little further down the road in differentiation and will grow new bone marrow and may grow other tissue but they are not especially efficient at that. There's research that's being done that says that they could grow heart tissue or even brain cells but that's very investigational."

:25

Bob Turner

14:37:12     S-603

"We work with a company called LIFECELL, that processes skin, and the uses for this skin are absolutely amazing. They process this skin in such a way that they remove from it any of the properties that would make someone else reject it. The biologic properties. They use this product the make from the skin, and if they for instance, wrap it around a ruptured Achilles tendon, the body turns that skin into tendon...tendon cells. If they use it to patch a hole in a baby's heart, it turns into heart muscle...if they use it to patch a defect in bone; the body turns it into bone."

:49

Shane

1:47:    S-534

"There some stuff coming down the pike as far as transplant itself...you know they do pancreas transplant but there's another procedure called "I-let"  cell transplant where they take a whole pancreas and spin it down and just get the "I-let" cells that produce insulin and then they'll inject those into the portal vein of the liver and the I-let cells just kind of set up shop and start producing insulin so that might be that kind of down the road that is the treatment for diabetes.

:37

George Selby, M.D.

47:50:

"The use of umbilical cord blood is going to be a growing area. The problem with umbilical cord blood is that since there is such a small volume of it and in umbilical cords, it's less than half a coke can in volume that's difficult to expect that volume of stem cells to repopulate the bone marrow of an adult. There so they have wider application in pediatric transplantation but if it could be expanded outside of the body, you know grown in a bucket so that you had enough of it and then give it all at once to an adult that would really be an amazing advance."

:45

VO : Robert

Those advances are at the forefront of research going on right now in Oklahoma.

Advances that will one day answer thousands of Oklahomans with the same simple prayer...let me live.

:12

Bob Turner

26:02:28     S-603

"The knowledge that something good came out of an otherwise senseless tragedy...that lives were saved. I've always been amazed that in spite of personal tragedy...at the worst moment in their lives, they can...make a decision that will spare other families from having to suffer as they are suffering."

:24

TRT

23:44

BOOTH

THE ORGAN DONOR INDICATOR ON THE OKLAHOMA DRIVER LICENSE IS AN IMPORTANT REMINDER FOR THE FAMILIES OF POTENTIAL DONORS.  BUT THE FINAL DECISION IS UP TO THE NEXT OF KIN.  SO IT'S IMPORTANT TO HAVE THAT DISCUSSION WELL IN ADVANCE OF ANY TRAGEDY SO THAT NO TIME IS LOST IN ANSWERING THE PRAYER OF THE THOUSANDS WHO REMAIN ON TRANSPLANT WAITING LISTS.

MUSIC

"LET ME LIVE..."

TRT